SERUM BIOACTIVE AND IMMUNOREACTIVE LUTEINIZING-HORMONE AND FOLLICLE-STIMULATING-HORMONE LEVELS IN WOMEN WITH CYCLE ABNORMALITIES, WITH OR WITHOUT POLYCYSTIC OVARIAN DISEASE
SERUM BIOACTIVE AND IMMUNOREACTIVE LUTEINIZING-HORMONE AND FOLLICLE-STIMULATING-HORMONE LEVELS IN WOMEN WITH CYCLE ABNORMALITIES, WITH OR WITHOUT POLYCYSTIC OVARIAN DISEASE
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DOI：
10.1210/jcem-73-4-811
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发表时间：
1991-10-01
影响因子：
5.8
通讯作者：
DAHL, KD
中科院分区：
文献类型：
--
作者：
FAUSER, BCJM;PACHE, TD;DAHL, KD
对35例周期异常妇女[11例有多囊卵巢疾病（PCOD），24例无多囊卵巢疾病（PCOD），根据严格的临床和生化标准]和8例周期正常妇女的早期（周期第3或4天）和中期（周期第7或8天）卵泡期的血清类固醇、促性腺激素和α-亚单位水平进行了评估。LH和FSH水平估计使用两种免疫技术[RIA和免疫放射测定法（IRMA）]和体外生物测定法（BIO），分别使用小鼠Leydig细胞和大鼠颗粒细胞。与对照周期和非PCOD患者的卵泡早期水平相比，PCOD患者的平均α-亚单位、游离雄激素指数[FAI;睾酮× 100/性激素结合球蛋白（SHBG）]、雄烯二酮、雌酮和雌二醇（E2）显著升高。此外，与对照值相比，PCOD患者的平均IRMA-LH和RIA-LH水平明显升高（分别为2.8- 3.6倍;两项比较，P < 0.001），但与非PCOD患者的数量级相同（1.3- 1.4倍增量）。然而，PCOD患者的中位BIO-LH水平比非PCOD患者高5.9倍，比对照妇女卵泡早期的BIO-LH高4.0倍。因此，与非PCOD患者相比，PCOD患者的中位BIO/IRMA-LH比值高4.8倍。在周期异常的女性中，个体BIO/IRMA-LH比值与BIO-LH（r（s）= 0.48）、FAI（r（s）= 0.39）、游离雌激素（E2/SHBG比值; r（s）= 0.047）和硫酸脱氢表雄酮（r（s）= 0.60）浓度相关。当比较各组时，平均IRMA、RIA和BIO-FSH水平以及BIO/IRMA-FSH比值无显著差异。尽管RIA和IRMA-LH水平显示出良好的相关性（r（s）= 0.88），但RIA-LH水平始终较高，导致RIA-LH/FSH比值明显较高（平均值，4.5）与IRMA-LH/FSH比值相比（中位数，1.8）。本研究中呈现的结果表明：1）当比较PCOD、非PCOD患者和对照组时，IRMA-FSH、RIA-FSH和BIO-FSH的平均血清水平没有差异; 2）IRMA法测定的PCOD患者LH/FSH比值明显低于RIA法（IRMA可能对识别PCOD患者没有用）; 3）与对照和非PCOD患者相比，PCOD患者中的游离α-亚单位水平升高; 4）与非PCOD患者相比，PCOD患者的BIO/IRMA-LH比值显著增加; 5）在周期异常的女性中，BIO/IRMA-LH比值与FAI，E2/SHBG比值和硫酸脱氢表雄酮水平相关。
Serum steroid, gonadotropin, and alpha-subunit levels were assessed in 35 women with cycle abnormalities [11 with and 24 without polycystic ovarian disease (PCOD) according to strict clinical and biochemical criteria] and 8 regularly cycling women in the early (cycle day 3 or 4) and mid (cycle day 7 or 8) follicular phase. LH and FSH levels were estimated using two immunological techniques [RIA and immunoradiometric assay (IRMA)] and in vitro bioassays (BIO), using mouse Leydig cells and rat granulosa cells, respectively. In PCOD patients mean alpha-subunit, free androgen index [FAI; testosterone x 100/sex hormone-binding globulin (SHBG)], androstenedione, estrone, and estradiol (E2) were significantly elevated compared to levels in the early follicular phase of control cycles and non-PCOD patients. In addition, in PCOD patients mean IRMA-LH and RIA-LH levels were distinctly increased (2.8- to 3.6 fold, respectively; both comparisons, P < 0.001) compared to control values, but in the same order of magnitude (1.3- to 1.4-fold increments) as that in non-PCOD patients. However, the median BIO-LH level in PCOD patients was 5.9-fold higher than that in non-PCOD patients and 4.0-fold higher than the BIO-LH in the early follicular phase of control women. Consequently, the median BIO/IRMA-LH ratio was 4.8-fold higher in PCOD patients compared to non-PCOD patients. In women with cycle abnormalities, individual BIO/IRMA-LH ratios correlated with BIO-LH (r(s) = 0.48), FAI (r(s) = 0.39), free estrogens (E2/SHBG ratios; r(s) = 0 0.47), and dehydroepiandrosterone sulfate (r(s) = 0.60) concentrations. Mean IRMA-, RIA-, and BIO-FSH levels and BIO/IRMA-FSH ratios were not significantly different when various groups were compared. Although RIA- and IRMA-LH levels showed good correlation (r(s) = 0.88), RIA-LH levels were consistently higher, resulting in distinctly higher RIA-LH/FSH ratios (mean, 4.5) compared to IRMA-LH/FSH ratios (median, 1.8) in PCOD patients.The results presented in this study indicate: 1) there were no differences in mean serum levels of IRMA-FSH, RIA-FSH, and BIO-FSH when comparing PCOD, non-PCOD patients, and controls; 2) the LH/FSH ratio estimated by IRMA in PCOD patients is substantially lower than that measured by RIA (IRMA may not be useful to identify PCOD patients); 3) free alpha-subunit levels in PCOD patients are elevated compared to those in controls and non-PCOD patients; 4) BIO/IRMA-LH ratios in PCOD patients are significantly increased compared to those in non-PCOD patients; and 5) in women with cycle abnormalities, BIO/IRMA-LH ratios are correlated with FAI, E2/SHBG ratios, and dehydroepiandrosterone sulfate levels.